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A population-based case–control study on viral infections and vaccinations and subsequent multiple sclerosis risk

  • NEURO-EPIDEMIOLOGY
  • Published:
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Abstract

Viral infections are probably involved in the pathogenesis of multiple sclerosis (MS). A recent cohort study in the Gothenburg population revealed no change in MS incidence associated with the introduction of the Swedish measles, mumps and rubella vaccination programmes. The aim of the present study was to clarify whether these infections or vaccinations, and two other infections, varicella and infectious mononucleosis, influence MS risk. We performed a population-based case–control study in Gothenburg that included 509 MS cases and 2,067 controls, born 1959–1986. Data on infections and vaccinations were obtained from questionnaires and from child health and school health records. We found no significant associations between measles, mumps, rubella or varicella and MS risk. These results were consistent between the two source materials. Infectious mononucleosis was associated with significantly higher MS risk (odds ratio 2.03, 95% CI 1.52–2.73). Overall, there was no significant association between measles-mumps-rubella (MMR) vaccination and MS risk, while those MMR vaccinated before age ten only were at significantly higher MS risk (odds ratio 4.92, 95% CI 1.97–12.20). Those MMR vaccinated both before and after age ten had intermediate MS risk. Infection with measles, mumps, rubella and varicella did not influence MS risk in contrast to infectious mononucleosis which conferred doubled MS risk. The association with ‘early’ MMR vaccination only was an isolated finding, limited by a small number of subjects and multiple testing. Most likely this was a chance finding. Future studies could investigate it on an a priori basis.

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Abbreviations

CI:

Confidence interval

CIS:

Clinically isolated syndrome

CSF:

Cerebrospinal fluid

EBV:

Epstein–Barr virus

MMR:

Measles-mumps-rubella

MRI:

Magnetic resonance imaging

MS:

Multiple sclerosis

OR:

Odds ratio

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Acknowledgments

We wish to thank Professor Lars Frisén for generous help in providing records of optic neuritis at the Neuro-ophthalmological Clinic, Sahlgrenska University Hospital; senior consultant Victoria Romanus for providing vaccination data from the Swedish Institute for Infectious Disease Control; Malte Nordqvist for technical assistance; and the Research Foundation of the Multiple Sclerosis Society of Gothenburg, Sweden, and the foundation of Anna-Lisa and Bror Björnsson, Gothenburg, Sweden for financial support.

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Authors and Affiliations

  1. Institute of Clinical Neuroscience, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden

    Cecilia Ahlgren & Oluf Andersen

  2. Institute of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

    Kjell Torén

  3. Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden

    Anders Odén

Authors
  1. Cecilia Ahlgren
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  2. Kjell Torén
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  3. Anders Odén
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  4. Oluf Andersen
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Correspondence to Cecilia Ahlgren.

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Ahlgren, C., Torén, K., Odén, A. et al. A population-based case–control study on viral infections and vaccinations and subsequent multiple sclerosis risk. Eur J Epidemiol 24, 541–552 (2009). https://doi.org/10.1007/s10654-009-9367-2

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  • DOI: https://doi.org/10.1007/s10654-009-9367-2

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